[MOL] Vaccine approach offers hope for kidney cancer.......Yippie! [00130] Medicine On Line

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[MOL] Vaccine approach offers hope for kidney cancer.......Yippie!

Vaccine approach offers hope for kidney cancer

NEW YORK, Mar 01 (Reuters Health) -- Study findings suggest that a vaccine designed to target cancer cells may offer hope to patients with advanced kidney cancer, a disease that currently carries a grim prognosis.

Researchers in Germany found that a vaccine made from a patient`s own cancer cells could fight advanced kidney cancer, tumors that had spread to other organs. In a study of 17 patients dying of the disease, seven responded to the treatment, including four who went into complete remission. Dr. Alexander Kugler of the University of Gottingen and his colleagues report the study results in the March issue of Nature Medicine.

Once kidney cancer spreads to other sites, such as the liver, lungs, and bones, it is "nearly impossible" to treat with conventional approaches like chemotherapy, according to Dr. Donald W. Kufe of the Dana-Farber Cancer Institute in Boston, Massachusetts.

In an interview with Reuters Health, Kufe said that the German study was the first clinical application of a cancer-vaccine approach he and other researchers have used in animal models. These vaccines consist of cancer cells that are fused with immune system cells called dendritic cells.

Vaccine therapy for cancer is based on the same premise as are disease-preventing vaccines: exposing the immune system to a foreign invader, or antigen, teaches it to recognize and destroy the antigen. Since tumor cells contain antigens, vaccine therapy aims to train the immune system to fight the cancer.

The dendritic cells used in the current study`s vaccine are antigen-presenting cells -- they display antigens on their surfaces to make them easier targets for the immune system`s killer cells. Recent research has shown that dendritic cells "are the best kind of antigen-presenting cells," Kufe said, adding that they are currently the "hot topic" in vaccine-therapy research.

In the German study, Kugler`s team electrically fused tumor cells with dendritic cells to create the vaccine -- theoretically, the dendritic cells should present the proteins on the tumor cells to the immune system, stimulating an attack. Patients received one injection, followed by a booster 6 weeks later. If their disease did not progress, they continued to get boosters every 3 months.

After up to 21 months of follow-up, four patients were in complete cancer remission, two were in partial remission, and one patient showed regression of the kidney tumors, but progression in tumors that had spread to bone. Eight of the 17 patients died or saw their cancer progress. No patients suffered a serious side effect from the vaccine.

Despite the number of patients who were not helped, the success of this study`s cancer vaccine is "unprecedented," according to Kufe. Once kidney cancer has spread to other organs, he said, fewer than 10% of patients respond to current therapies, and most die within months. The study results should also spur research into treating other cancers with similar vaccines, he noted.

If longer follow-up and future research confirm the current findings, Kufe said, the vaccine would initially be used following surgery in patients whose cancer had spread extensively. Considering the lack of treatment options for advanced kidney cancer, he added, vaccine therapy could become the first-line treatment.

SOURCE: Nature Medicine 2000;6:252-253, 332-336.

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